Policy & Regulations

This channel includes news coverage of healthcare policy and regulations set by Congress, the states, Centers for Disease Control and Prevention (CDC), the Department of Health and Human Services (HHS), U.S. Food and Drug Administration (FDA), and medical associations and societies. 

Aetna leaving many ACA exchanges, reversing earlier plans

Aetna will exit 11 of the 15 state marketplaces where it currently offers coverage on the Affordable Care Act, citing the same “continued financial stress” as other large insurers that are scaling back exchange business in 2017.

Analysis: Insurers asking for 24 percent hike in premiums on ACA-compliant plans

Insurance companies offering coverage on the individual market have requested a 24 percent average increase in premiums for 2017, according to a new analysis.

ACA rate reviews being used by insurers in unforeseen way

The rate review mechanism enacted by the Affordable Care Act was intended to shame health insurers that asked for large premium hikes, but as the New York Times reports, insurers are trying to use it to their advantage for 2017.

Pathway Health to get a tech upgrade through Virtual Health partnership

Pathway Health, a post-acute consulting firm, and Virtual Health, a population health management technology provider, have entered into a partnership that will provide Pathway with strategic consulting services to improve technology and payment models.

APA warns psychiatrists against diagnosing public figures from afar

When public figures act or speak differently than usual—or differently than anyone else around them—some people (and the media that cater to them) look for medical or mental-health related explanations. But the American Psychiatric Association (APA) has issued a reminder to its members: Don’t engage in such public analysis diagnostics when you don’t actually know the person in question. 

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State news: Calif. insurer to close for one week; math mistakes cost hospitals in Mass, R.I. millions

Here’s a roundup of the latest state healthcare news, including a deadly bacteria closing down a Maryland neonatal intensive care unit and why one state lawmaker in Missouri has been blocking efforts to create a prescription drug monitoring database.

CMS updates team-based home care program

With enrollment in Programs of All-Inclusive Care for the Elderly (PACE) increasing by 60 percent in the past five years, CMS is proposing changes to “modernize” the team-based home care services program for Medicare and Medicaid beneficiaries.

Hospitals avoiding risky transplants to boost success rates

STAT News reports hospitals are increasingly reluctant to perform transplants involving extremely ill patients or less-than-perfect organs, fearing poor surgical outcomes could lead to reduced hospital ratings and Medicare funding.

Around the web

The tirzepatide shortage that first began in 2022 has been resolved. Drug companies distributing compounded versions of the popular drug now have two to three more months to distribute their remaining supply.

The 24 members of the House Task Force on AI—12 reps from each party—have posted a 253-page report detailing their bipartisan vision for encouraging innovation while minimizing risks. 

Merck sent Hansoh Pharma, a Chinese biopharmaceutical company, an upfront payment of $112 million to license a new investigational GLP-1 receptor agonist. There could be many more payments to come if certain milestones are met.